Healthcare Provider Details

I. General information

NPI: 1811019805
Provider Name (Legal Business Name): ARSALAN RANGCHI D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 GILMAN ST SUITE A
BERKELEY CA
94706-2431
US

IV. Provider business mailing address

1313 GILMAN ST SUITE A
BERKELEY CA
94706-2431
US

V. Phone/Fax

Practice location:
  • Phone: 510-524-3025
  • Fax: 510-526-1027
Mailing address:
  • Phone: 510-524-3025
  • Fax: 510-526-1027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number50352
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: